Personalized medicine improves outcomes and reduces costs by enabling more accurate diagnoses and more optimal treatments. Patients are back to health and back to work more quickly, thus reducing the impact on an individual's life and the overall economic burden of disease.
In orthopedic and neurological surgery, intervention often results in placement of a permanent implant. On a patient-specific basis, the implant's physical environment potentially provides a wealth of diagnostic data regarding the progression of healing and prognosis of an outcome. Earlier detection of failure fosters earlier revision. Earlier diagnosis of healing fosters earlier return to work. In this way, the clinical utility of smart implants in musculoskeletal disease is vast. There are clinical indications in many areas of clinical medicine which are opportunities for smart implant-based diagnosis, intra-operative monitoring and personalized post-operative care to reduce the burden of the disease.
For musculoskeletal diseases, implants are an opportune vehicle for facilitating personalized medicine. “Smart implants” can be used to house implantable sensors that measure the local physical environment and provide quantitative real time patient-specific data that cannot be obtained any other way. Such data can be provided to the caregiver or directly to the patient to facilitate accurate diagnoses, guide treatments, and optimized rehabilitation and therapy.
Since the 1960's, the clinical value of implantable sensors in orthopedic and neurological surgery has been demonstrated in the research literature. Yet, for the last 45 years, the technology has not been translated into clinical practice. Implantable systems for research have been too bulky, too expensive, prone to failure due to complexity, and have necessitated surgical modification to the clinical implants which act as vehicles to carry sensors into the body. This has relegated implantable sensors to pre-clinical studies and very small patient populations in research studies. For smart implants to become part of clinical practice, the sensors must be robust, inexpensive, and compatible with off-the-shelf implants.